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A Rare Case Report on Bowel Obstruction due to Seed Bezoar at the Rectum
Kritick Bhandari1, Maria Qadri2, Saili Chothe3
1Department of Internal Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
Abstract:
Bezoars are rare gastrointestinal masses composed of indigestible substances, typically found in the stomach but at times occurring at more distal locations. Rectal seed bezoars are particularly unusual and manifest with nonspecific gastrointestinal complaints, predisposing to making the diagnosis difficult and delaying appropriate therapy. We describe a case of a 68-year-old female presenting with acute constipation, tenderness of the rectum, and per-rectal bleeding. The patient had a history of recent consumption of approximately 100 g of sunflower seeds. Examination and imaging of the abdomen revealed findings of obstruction at the rectum. Following the rectal enema, the patient passed a clumped mass of sunflower seeds per rectum, which is consistent with a rectal seed bezoar. She was treated conservatively with stool softeners, antibiotics, ointments, and sitz baths. This case is striking because it illustrates the clinical significance of rectal seed bezoars as a rare but reversible cause of acute constipation. Strong suspicion, meticulous dietary history, and focused examination are needed for diagnosis. Early diagnosis and conservative management can prevent complications and make the employment of invasive diagnostics unnecessary.
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